Patients deserve prescription for easy access to medical files

In a 1996 episode of the classic sitcom, Seinfeld, Elaine sneaks a peek at her medical file while waiting alone on an examination table in her doctor's office.

"Difficult?" she reads aloud, as she discovers that a medical staffer once described her with the unfavourable adjective and wrote it down in her file. That's when her physician walks in and scolds her.

"Elaine, you shouldn't be reading that," he says as he grabs the file from her hands.

Almost two decades after that hilarious episode first aired, patients still tend to feel a sense of mystery surrounding their own medical records. They feel they are doing something wrong if they manage to read a note their doctor scribbled down about them.

They feel like spies if they catch a glimpse of their own medical test results. But that shouldn't be the case, argues an editorial set to be published online today by a prominent Canadian medical journal. Patients should have easy access to their health records -- and physicians need to be the ones to lead the way to this goal, says the editorial.

Easy access to one's own medical files is more than just about the principle of transparency; it's a matter of life or death.

Take the case of someone I know -- a family member -- who experienced chest pains before visiting a hospital emergency room in Winnipeg. When ER staff told her their diagnostic tests did not reveal a medical problem, she went home relieved but baffled.

The chest pains would hit again intermittently. Over the next couple of months, she visited two different hospital ERs at least five more times. Their tests still came back negative. Doctors told her she had muscle spasms and should try anti-anxiety medication.

She finally made an appointment with a heart specialist and family friend. That physician gathered her tests from the different hospitals she visited in the weeks earlier. The specialist found irregularities in all the tests; he felt they all suggested a heart problem.

His own tests confirmed it: she had angina. She had emergency heart surgery within days that likely saved her life.

Why the ER staff didn't catch the serious heart issue isn't the point here. It's more about having access to your own test results.

This story is a lesson: Always ask for copies of your test results, whether at a doctor's office or in a hospital ER. Keep them in your own folder. Even though you may have no idea what the results mean, you may need to share the information with another doctor one day. Or perhaps you want to research the information yourself so you have a better understanding of what's happening with your body.

In Canada, patients have the legal right to access their own health information. Rules vary by province. In Manitoba, you can access it under the province's Personal Health Information Act.

The act isn't perfect; medical-care facilities are not obliged to hand over your information within a particular deadline. Rather, they must "respond to your request" in a particular time frame, meaning they must tell you they are looking into your request, says a spokeswoman for the province.

Getting such a response could take up to 30 days in certain circumstances, according to the act.

There's no question that the act needs to be changed.

However, accessing your medical records quickly is possible, particularly if you build a relationship with your doctors and their staff.

A doctor at one clinic I visit often turns his screen towards me when he's discussing my medical results so I can see what he's talking about. At the end of our appointments, he has no problem printing them off for me and handing them to me on the spot.

At that same clinic, the nurses have also made copies of test results without much hassle.

My GP offers the same service: He prints tests results out for me without blinking.

The receptionist at another clinic I attend once asked me to send her a self-addressed stamped envelope so she could mail me my test results when I asked for them. Annoying but doable.

Another doctor I see offered to read me a letter he received about me from another specialist he referred me to. I discovered a mistake in the letter -- a serious one in which the doctor who wrote it mistakenly misidentified my medical condition. At my next appointment with the doctor who wrote the letter, I pointed out the mistake.

A few months ago, a pediatric specialist I used to see as a child also offered to give me my old medical file if I need it. She said she could give me a copy on the same day I asked her for it. (We agreed the information in the file could help me gain some insight to my health today).

The information in your medical files gives you power over your own health. You have the right to access it. It could even save your life. There are many responsible doctors (and medical support staff) who already allow patients to access this information easily.

Don't be afraid to ask.

Have an interesting story idea you'd like Shamona to write about? Contact her at shamona.harnett@freepress.mb.ca.

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